On Thursday, US surgeon general Vivek Murthy released a 53 page report detailing the current adolescent mental health crisis. And it is grim. In fact, we've moved past crisis to full on emergency.
Included in the report (you can read the NYTimes synopsis HERE) was the following, which I hope you will really let sink in for a moment.
“In the United States, emergency room visits for suicide attempts rose 51 percent for adolescent girls in early 2021 as compared to the same period in 2019. The figure rose 4 percent for boys.”
We are losing girls. Also boys, but a staggering amount of girls to mental health crisis.
This begs the question, why?
And I've thought about this a lot. Run through all the scenarios, thought about all of my past patients, the hospitals, high schools, colleges I worked at. My colleagues who have dedicated their lives to lovingly and passionately serving adolescents in a multitude of roles related to mental health and social services.
And my conclusion is always the same.
The truth is, as a society, we don't give a shit about kids. We don't. If we did, things would look a lot different.
For one, our maternal mortality rate would not be the highest in the world among high resource countries. There would not be a debate about paternal leave, equitable access to healthcare, climate crisis, or gun control.
Social services available to children who have parents receiving in-patient recovery treatment, in prison, or are unsafe for them to live with would have better options than the overcrowded an underserved group home and foster system. Currently, in this country there are 162,000 children who have lost a parent or caregiver to COVID-19. We are about to test our social services system like never before.
Also, our schools, where most children spend 5-8 hours a day would be more than adequately resourced. All schools would have a team of nurses on campus 5 days a week, along with a hefty cohort of well seasoned therapists, learning specialists and substance abuse counselors. And hefty means more than one of each per 2,000-3,000 students to serve.
And most importantly, children and their families in the midst of a mental health crisis would have a variety of free and available treatment options from inpatient to outpatient and everything in between, instead of one, if they are lucky.
And maybe we would do away with juvenile detention centers altogether.
The truth is ugly, but essential to consider.
The saddest part in all of this is that kids know. They know that we don't give a shit and they know that there is little hope for change. And to be honest, I have little hope for change on the grand scale. I assume that from this report, money will be put aside to address some of these issues on a federal level, but it will not be enough.
It's time to treat this emergency like triage. Kids need tools and parents need tools. And I need to stop telling a story many of you already know and start sharing what I know that can help.
So here it goes.
Therapy is an answer. It's not the only one, but it just might be the best. I deeply believe in psychoanalytic and psychodynamic therapy, but there are many different effective modalities. And many different ways to work with kids. And the time is now. No matter the age.
One does not need to be in crisis to enter into therapy. In fact, we are all deserving of the undivided attention of a professional to gain a better understanding of ourselves, nor matter the frame of mind or age. And this is a powerful thing for kids.
Parents are not impartial. Our perspective is often collapsed with regards our own kids and we are constantly triggered by them. A therapist offers kids a place to explore without all of our garbage and projections. Therapy for kids is giving them the gift of getting to know themselves in a way their parents and peers cannot provide.
Therapy will look very different for a 14 year old than a 4 year old and that's a good thing. Kids need different kinds of metaphoric holding at different ages. But make no mistake, therapy is a good thing at any age.
Start them now.
Kids from infancy through their 20's require presence and care. And it does not really waver just because they are older. It just looks different. Whether offered by a parent, older sibling, auntie or uncle, or grandparent, kids need adult presence, even when they do not interact with it. And this is not easy and can feel like a huge time suck. But it is necessary.
What this looks like is being available. And that doesn't mean following them around or sitting in a chair staring into space waiting for them to talk to you. They most likely won't, but it means reading a book in the same room they are doing their homework, being busy in the kitchen with a task while they are eating a snack. My friend's mom famously used to sweep the kitchen when I would visit. It took me years to realize that there was no way the kitchen had to be swept a few times over the course of a day. That was just her way of being around every now and then without being intrusive. Sweeping or reading doesn't need to be your thing, but find out what it is and commit to being available.
Be interested in what they love. Even if you hate it. Don't be the dad who becomes distant because the kid no longer likes baseball and that's the thing you did together. This is all too common. A lot of the stuff kids like is annoying and really uninteresting. To us. But to them it is their world. Send time with them doing what they love to do. There are plenty of opportunities for common ground, but they only come if you ask and are interested.
Therapy can provide kids with great autonomy. They learn about themselves, what they think and feel and how they behave. It really is the greatest gift. But there are many other ways to help kids discover autonomy when it coms to their mental health. Education, books, apps, podcasts can help too. Technology in this way is a great tool. A few of my favorite resources for parents to explore before sharing are:
TALK TO THEM
Contrary to popular belief, talking to kids about things doesn't encourage them to do it. Conversations about sex don't suddenly encourage kids to have sex. The same goes for suicide, equality and racism. Pretending thorny issues do not exist creates an environment of secrecy and shame. However, being open to conversations that might make us uncomfortable is not the same thing as needlessly saturating kids with information. Kids do not need to listen to the news in the car, or have CNN in the background all day, if at all. There is a balance between being informed and carelessly reinforcing how little control they have over their world right now. Like I said, we are fucking up and they know it. They are able to see videos of murder happening in real time on social media. Keep their immediate environment a sanctuary.
TAKE OUT THE TRASH
Want to really help kids? Sort through your own emotional garbage. Whatever that looks like for you. Whether it is therapy, a recovery community, coaching, or meditation, pick something and get to know yourself. Stop reacting and start responding. Model good boundaries, healthy choices, and self compassion to your kids. Stop telling them and start showing them how to feel good, navigate seemingly insurmountable challenges and sort through what is coming up instead of pushing it down inside. Be what you are asking of them. We are all scared. Show them that fear, grief, disappointment, heartache, and loss are survivable.
These are just a few ideas and included here because they apply to most situations. This list is not meant to just sit here without support. Nor is it meant to be tackled all at once. Support is not built in a day. I'm here to help. Want to know how to find a therapist for your kid? How to figure out of therapy is covered by your insurance? What play therapy is? Send me your questions. I am here to help educate. That's my role.